Kidney
SECTION A: Read each question carefully and record the answer "TRUE" or "FALSE",•
1. In a normal 65 kg man, the following statements are true
a) total body water is approximately 40 litres
b) 70% of the total body water is intracellular
c) 75% of extracellular water is intravascular
d) sodium, bicarbonate and chloride ions are mainly Intracellular
e) potassium, magnesium, phosphate and sulphate ions are mainly extracellular
2. Within the normal kidney
a) 33% of the filtered water is reabsorbed in the proximal tubules
b) antidiuretic hormone (ARM) increases the water permeability of the distal tubules
c) the glomerular filtrate contains about 200 mg protein per litre
d) 33% of the filtered sodium is reabsorbed in the proximal tubules
e) the juxtaglomerular apparatus comprises specialised cells of the efferent arterioles and proximal
3. Clinical features of hyperkalaemia include
a) tall peaked T waves and ST depression on isCQ
b) asystole and ventricular fibrillation
c) peripheral paraesthesiae
d) widening of the QRS and conduction defects on ECG
e) symptoms and signs indistinguishable from those induced by hypokalaemia
4. Metabolic acidosis Induced by the following disorders Is typically associated with an Increased
a) plasma bicarbonate concentration in lactic acidosis
b) anion gap in starvation acidosis
c) blood Paco2 in diabetic ketoacidosis
d) plasma chloride concentration In proximal (type ii) renal tubular acidosis
e) red cell carbonic acid production during aceta_zolamlde therapy
5. The kidney produces the following substances
a) erythropoietin
b) 25 hydroxyoholecalciferol
c) prostaglandins PGE, and PGI
d) anglotensin-converting enzyme
e) aldosterone
6. Proteinuria in excess of 3,5 g per day Is a typical feature of
a) cardiac failure
b) polycystic renal disease
c) renal amylQidosis
d) minimal change nephropathy
e) chronic pyelonephritis
7. Microscopic haematuria would be an expected finding in
a) urinary tract infection
b) renal papillary necrosis .
c) membranous glomerulonephritis
d) Infective endocarditis
e) renal infarction
8.Typical features of the acute glomerulonephritis syndrome include
a) bilateral renal angle pain and tenderness
b) hypertension and periorbital facial oedema
c) oliguria < 800 ml and haematuria
d) highly selective proteinuria *
e) history of allergy with oedema of the lips
9.Typical features of the nephritic syndrome include
a) bilateral renal angle pain
b) generalised oedema and pleura! effusions
c) hypoalbuminaemia and proteinuria > 3.5 g /day
d) hypertension and polyuria
e) urinary sodium concentration > 20 mmol/L
10.Characteristic features of minimal change nephropathy are
a) occurrence in adults usually follows an acute infection
b) marked mesangial cell proliferation on renal biopsy
c) nephrotic syndrome with unselective proteinuria
d) hypertension and microscopic haematuria
e) progression to chronic failure in patients not responding to corticosteroid therapy
11.The typical features of lower urinary tract infections (UTIs) include
a) rigors, loin pain and renal impairment
b) suprapubic pain, dysuria and haematuria
c) progression to acute pyelonephritis if untreated
d) midstream urine culture producing Escherichia coli> 100000 /ml
e) the drug of choice for the majority is ciprofloxacin
12.Complications of chronic renal failure include
a) macrocytic anaemia
b) peripheral neuropathy
c) bone pain
d) pericarditis
e) metabolic alkalosis
13.Typical biochemical features of chronic renal failure Include
a) impaired urinary concentrating ability
b) hypophosphataemia
c) hypercalcaemia
d) metabolic acidosis
e) proteinuria > 3.5 g/day
14.Disorders predisposing to renal stone formation Include
a) urinary tract infection
b) prolonged immobilization
c) hypoparathyroidism
d) renal tubular acidosis
e) sarcoidosis
15.The clinical features of adult polycystic renal disease Include
a. an autosomal recessive mode of inheritance
b. cystic disease of the liver and pancreas
c. renal angle pain and haematuria
d. aortic and mitral regurgitation
e. aneurysms of the circle of Willis
16.The typical features of acute pyelonephritis in. adults include
a. normal anatomy of the urinary tract
b. vomiting, rigors and renal angle tenderness
c. renal angle pain is usually bilateral
d. evidence of reflux on isotope renography
e. loin pain and fullness in the flank
17.During the diuretic phase of acute renal failure ,
a. the blood urea concentration decreases
b. increases in the dietary protein intake should be avoided
c. sodium and bicarbonate supplementation is required
d. fluid restriction should be maintained
e. renal medullary dysfunction typically persists for 2-3 months
18.The typical features of established acute renal failure Include
a. olkjuria < 800 ml per day indicates irreversibility
b. systemic hypertension with significant renal ischemia
c. urinary osmolality > 600 mosm/kg indicates acute tubular necrosis
d. urinary sodium concentration < 20 mmol/L indicates irreversibility
e. anaemia with a haemoglobin concentration < 80 g/L
19.Treatment of the ollguric phase of acute renal failure
Includes I
a. restriction of dietary protein to 40 g per day
b. calcium resonium orally and/or rectally to reduce hyperkalaemia
c. restriction of fluid intake to the total volume of daily losses
d. tetracycline therapy if enterocolitis supervenes
e. avoidance of dialysis if pulmonary oedema supervenes
20.The following drugs should be avoided in moderate or severe renal failure
a. gentamicin
b. oxytetracycline
c. morphine
d. rneialazine
e. melformin
SECTION B: Only one Item appropriately applies to the Statement.
21. Complications of long term dialysis include all the following EXCEPT.
a) Increased risk of gastrointestinal malignancy,
b) Myocardial infarction,
c) Carpal tunnel syndrome.
d) Protein Calorie malnutrition.
e) High output congestive heart failure
22. A 55 year old diabetic woman with end stage renal disease(ESRD),has been treated with peritoneal dialysis (prescription of four echanges,2 L exchange per day for 6 years,She is 80 kg.The patient complains of nausea fatigue, abdominal discomfort, Medications include Erythropoetin, Calcium carbonate, water soluble vitamins. Lab studies showed hematocrite 38%, blood urea 160 mg/di, Serum creatinine 13 mg/dl, bicarbonate 14 meq/I, Calcium 10 mg/dl, Phosphate 2.3 mg/dl. Thlp most likely dlpgtnosis is:,
a) Mycobacterial peritonitis.
b) Dialysis dysequilibrium.
c) Uremia due to under dialysis,
d) Peritoneal carcinornatosis,
e) Diabetic ketoacidosis
ليست هناك تعليقات:
إرسال تعليق